1. The Final Passage
Chapter 16

2. DO NOT STAND AT MY GRAVE AND WEEP Mary Elizabeth Frye (1904-2004)
Do not stand at my grave and weep, I am not there, I do not sleep. I am a thousand winds that blow, I am the softly falling snow. I am the gentle showers of rain, I am the fields of ripening grain. I am in the morning hush, I am in the graceful rush Of beautiful birds in circling flight. I am the starshine of the night. I am in the flowers that bloom, I am in a quiet room. I am in the birds that sing, I am in each lovely thing. Do not stand at my grave and cry, I am not there -- I do not die

3. What comes to mind when you hear the word Death?

4. Views are culture dependent
Buddhist’s – reincarnation
American’s – sadness and loss
Hispanics – celebration and encouragement for spirits (don’t celebrate death, but that the spirit lives!!)

5. Remember the Terri Schiavo Case?
What was your view of this case?

6. Clinical death – lack of heart beat and respiration Brain death
no spontaneous movement
No spontaneous respiration
Lack of responsiveness
No eye movement
No postural activity
No motor reflect
Flat EEG for at least 10 minutes
No chang ein any criteria after tested again in 24 hours

7. EUTHANASIA Dr. Kevorkian Deliberate ending of someone’s life Oregon
Drug overdose
Disconnecting life-support
Mercy killing
Oregon
Death by Dignity Act in 1994
Makes it legal for people to request a lethal dose of medication if they have a terminal illness and make the request voluntarily

8. Active euthanasia – inject with something, smother, etc.
Passive euthanasia – involves allowing a person to die by withholding available treatment
Chemotherapy
Surgery
What would you want to occur if you were in a situation where you could not make your wishes known?

9. Durable power of attourny
Living Will – person states his/her wishes about life support and other treatments and makes others aware of their durable power of attorney (person who has legal right to make decisions on your behalf)
Basis for DNR
Durable power of attourny

10. How do you feel about dying?

11. The shift from formal operational to postformal operational thinking impacts contemplation of death
Older adults are less anxious and more accepting of death

12. Kristy L. Norris January 24, 1980 to September 12, 2063
Died this last Tuesday morning of health complications in her home
in Beverly Hills. She is survived by her three children: Lena Rebecca,
Samuel Lynn, and Delilah Jane Jones and a multitude of grandchildren. During her life,
Ms. Jones was able to touch the lives of many people. Mrs. Norris was a teacher
at Western Kentucky University for 10 years prior to moving to California.
During her time in California Mrs. Norris was able to bless many families and provide therapy for the underprivileged for over 40 years. After her retirement, Mrs. Norris continued
to touch lives through her charity work and community commitment.
Memorial set for Thursday September 14th in California,
Saturday and Sunday the 15th and 16th in Columbia, Kentucky
Mrs. Norris’ ashes will be spread next to her husband in
Green River on Sunday September 16, 2063.
Life is short, enjoy the time you have and enjoy it to the fullest.
-Kristy L. Jones

13. FINAL EXTRA CREDIT OPPORTUNITY Write your obituary
FINAL EXTRA CREDIT OPPORTUNITY Write your obituary. Turn it in on Exam day with your final reflection paper.

14. Elisabeth Kubler-Ross theory of dying.
Denial
Anger
Bargaining
Depression
Acceptance

15. Most want to control the final part of their lives and contemplate such things as care, choices for ending life, and what their last wishes are.
Final Scenario – making these choices
When this process is complete, it is a lot easier for survivors to deal with closure.

16. Hospice care
Only after doctor and patient feel there is no treatment/cure possible
Kept pain free
Maintains dignity

17. What about those who are alive?
How have you dealt with grief in the past?

18. Grief is an active process
Acknowledge loss
Work through emotions
Adjust to absence
Loosen ties to the deceased
What are normal grief reactions?
A highly individualized process
Anniversary reaction

19. Factors impacting grief
Age
Gender
Personality
Religion
Evidence suggests that church attendance helps people deal with bereavement 13 to 18 months after the loss.
Connection to deceased

20. Loss across the Life Span
Children
Preschoolers tend to believe death is temporary
3 developmental changes impact grief:
Cognitive language ability – ability to talk about what they are experiencing and understand.
Psychosocial development – Erikson would say that they are dealing with the initiative v/s guilt
Coping Skills – more limited in children, may feel guilty, wish for return of lost
Make sure young children understand that it’s ok to feel sad, cry or show emotions.
AND ……BE HONEST WITH THEM!!!!!!!!!!

21. Adolescents/Teens
When loss is a sibling child may not want to appear different from peers and bottle up feelings, often times quiet
Survivor guilt
Loss of a parent is similar to loss of sibling. Will maintain a place for lost parent
Little is known about response to loss of friend/peer

22. Adults Often more intense in feelings toward death
Young adult widows show levels of grief until 5 to 10 years after the loss
By middle life most have confronted death of parents and foresee their own death
Expressing feelings toward ones parents before their death is important!
Worst type of loss if the loss of a child for most
Miscarriage/abortion/ neonatal death is overlooked and grief process not usually explored

23. Late Adulthood
Anxious about death their selves and more accepting than other age groups
Due to achievement of ego integrity
Grieve for a long time after loss of spouse (up to 30 months)